Nursing Communication: Assertive Framework and Case Study Report

This report delves into the critical role of assertive communication within the nursing profession. It highlights the importance of effective communication skills, both verbal and non-verbal, in building trust and confidence among healthcare stakeholders, particularly nurses. The report focuses on assertive communication as a vital framework, essential for navigating interactions with patients, doctors, and families. Using a hypothetical scenario involving a patient with a serious head injury, the report applies communication models like the "See it, Say it, Fix it" and the "Five-step model" to demonstrate how nurses can effectively manage challenging situations. It emphasizes the need for nurses to be empathetic, provide clear explanations, and maintain professional confidence while advocating for patients' rights. The report underscores the significance of direct communication, maintaining eye contact, using understandable language, and seeking feedback to avoid misunderstandings. It concludes by stressing the need for assertive communication training in nursing education and its role in fostering professional growth and improved patient care. The report highlights the importance of assertive communication in the healthcare environment, emphasizing that it is not about aggression but rather about self-assurance and effective expression.

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Nursing Communication
For all aspect of life, there are different type of skills that are required in order to make sure
that the work is being complemented in an effective manner. In this context, communication
can be determined to be one of the effective skills that enables to develop trust and
confidence among others. These are of two types which are non verbal and verbal
communication. In order to have a harmonious personal life, it is essential to have robust
communication skills. Though, strong communications skills can help an individual to excel
in any profession, but these prove to be a pivotal set of skills for some professionalsviz.
healthcare or nursing. Among all the members who are involved in healthcare organization,
the only member who have effective interaction with the stakeholders are nurses. They are
able to eliminate the gap that other have and this is done by them with the help of effective
communication. Nurses are anticipated to judge the situation and use apt set of
communication framework while having proper communication in order to access
disciplines, hospitals or units.
The present paper deliberates one such important communication framework i.e. assertive
communication which is used during nursing communications. The paper uses a hypothetical
scenario as an example. In this context, it covers different areas that enable to understand and
raise learning for communication.
Assertiveness can be determined to be the once belief, meeds, opinions, honesty and
openly. Further, it is also considered that there is no violation made for the rights to
individuals (Ellis & Hartley, 2005). In this context, it is essential that nurses need to be
submissive and aquiescent, tyhis is the time when there is communication going on with
patients, doctors, family/caregiver (Slater 1990; Poroch & McIntosh 1995). But, it is been
identified that there is an change that is identified in the profession of nurses. In this context,
the changes are identified in areas of their roles, legal rights and healthcare laws. Due to these
changes, nurses are exposed to make use of other frameworks related with communication.
With this respect, assertive communication is considered to be one of them. As per the
meaning, assertive does not mean to be rude while having interaction with others. However,
it simply means to raise once voice in an positive manner by staying calm and standing for
other people’s right. It is being identified that some of the individuals have this assertive
communication naturally and there are some of them who need to develop them. There are
basically two model that can be used with the help of which assertive communication in

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nursing can be practices effectively. With this respect, one of the model is “See it, Say it, Fix
it”. As per this model, it understands the type of situation and focus on analytical aspect and
they think in order to communicate with others. On the other hand, another model is “Five-
step model”. In accordance with this model, there are about 5 steps approaches used and
these are helpful enough to overcome the problem and also make use of effective
communication with the help of which proper interaction take place.
For example, the present case is on communicating with friend and family members of a
patient who is bought to hospital due to serious head injury. The nurse supposed to provide
the family that patient is unconscious and it is important to make sure that he is shifted to
intensive care unit. When information was conveyed, the response of members was not
favourable as they get aggressive for not providing the information sooner. In such situation,
it is important to understand the condition of family members and nurse should accept the
aggressive nature and this situation can affect the nurse in negative manner. As quoted by
George Bernard Shaw “the greatest problem in communication is the illusion that it has been
accomplished.” It is essential for the nurse to show empathy to the family members. But there
are conditions in which it could give a wrong message of negligence on part of hospital and
healthcare team. It is essential to have assertive communication by nurses and proper
explanation should be provided (O’Mara 1995). This will clarify one’s needs to the other
person. Hence, in such scenario an assertive framework of communication is required. As per
the views of Burnard (1992), assertiveness is helpful to depicts professional confidence and
it is required to be encouraged.
The current case script has proposed the application of five stage framework of an imperative
communication. A thorough and clear interaction is referred to be one of the most crucial
component of assertive communication. Herein, this is duly important for the health
professional such as nurse to directly stay in the communication with the family members of
the patient. It is necessary that the nurse call them by their name (if not known, may ask first
whom he/she is speaking too). This creates a sense of familiarity with the respective members
of the family by providing a well acquainted feeling for the nurse that will result in the
provisioning of effective care to the patient. However, the use of mediate methods for
addressing the issues gives an impression of lack of knowledge about the patient. Second
important thing is maintaining the eye-contact while talking with the family. It in turn
indicates a sense of assurance in the way one refer to communicate with other. Selecting the
terms is referred to be yet other important aspect. The content needed to be transmitted to the

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family should reflect clear and precise in a language understandable to them. Try not to use
too much medical vocabulary or jargons, as these might create confusion in the family
members. It is also required that a nurse explain the further plan of management, why it is
required for the patient, and how the healthcare team will execute it to the family. A nurse
should always ask for a feedback once the explanation/ information is provided to the family.
This reduces the chances of misinterpretation.
The second element of assertive communication is being apologetic about any delays or
inconvenience caused by the group of health care team or people who are in equivalence to
them. It is in accordance to the delineated clauses in the chosen case script, the others
members of the family are previously ferocious towards the paused information about their
patient. So, it is indispensable for the health care providers handling this case to empathise
such condition and provide a legit statement about such delayed information and its cause of
getting hold. It is advised that a nurse should not built up any lame stories to coverup the
mistakes by the healthcare team in delaying the information to the family. Rather, in such
case it is required that a nurse accept the fault on the counterpart and give a genuine
explanation the delay.
The third most important element in assertive communication framework is to understand the
rights and voice your opinion. It is necessary for a nurse to understand that being accepting
and subservient is not part of the job responsibility. It is required that a nurse should stand for
his/her own dignity and pride. Penetration of individual space must not be acknowledged
despite of dealing with a heartache family who is in grief. It is in concord to the delineated
hypothetical situation, the respective members of the patient's family were found to intrude
onto the personal consideration by poking the back of the practitioners rendering their
services. Hence, under this type of condition, the professional dealing with such situation
must explicit the discomfort created in a firm voice, explain that such gestures are
unacceptable, and if require warn the family member of strict action if this kind of behaviour
is repeated. Even though, such interaction is needed in such situation where maximum
number of nurses tends to hold back from the use of aggressive communication. It is in
accordance to the given statement of Valentine (1995), the health professional are known to
believe on the concept of resolving a issue by taking care of an individual by complying by
their interpersonal rather than themselves being the reason of a disputed matter and raising
their voice against someone.

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However, the nurses are hereby required to make a primary interpretation of self-
assertiveness that is a positive thought and makes one able to clearly explicit one’s own
thoughts and ideas in an honourable way. Wherein, it does not intend to violate the individual
right of others. It is in accord to the assumed case script, where there was a prime
requirement of being assertive. It is by directly explicating the uneasiness against the
intrusion of individual space by frankly explicating the reason of pause in provisioning the
condition of the patient to the concerned members of the family. This must not be referred to
be a an assertive behaviour by the nurse towards them. Instead, clarity along with a direct
interaction is apparent to support the health care practitioner to develop a strengthened
interpersonal relationship with the respective members of a patient's family. Peplau, 1997
together declared a prime importance of such social relationship in a health care setting.
Creating a confiding social relationship permit the healthcare professionals to propose some
effective ways by openly interacting with the patients as well as with their family members
and be positively assertive while taking care of the patient's needs.
Another important aspect of interaction in this scenario is the understandability towards the
communication. Wherein, the respective members of patient's family are often not well aware
of the exact situation and tends to develop a sense of anger towards the practitioners taking
care of the patient in a health care setting. As a result to which, they hereby state it to be a
part of negligence by the nurses attending the patient. Hence, it is important that a nurse bring
out a clear communication with the family member. A nurse should clearly explain the events
as they have happened once the patient has been admitted to the hospital. The exact
procedures which are carried out and their relevance for interest of patient health. It is also
necessary that the nurse have a clarity while informing another stage that are being planned
for the patient by together defining the way in which the referred steps will be undertaken. A
precise statement by the nurse will in turn assist the family members to assure a confident
outlook towards the team of healthcare professionals and the strategies that are being
projected by the administration to treat the patient. It is also vital to gain consent from them
regarding medical procedures.
Nurses are a very resourceful member of the health care team, they are efficient in drawing
variety of physical and psychological intervention that facilitates management of the patients
and provide empathy to the care providers. However, it has been observed that nurses are
often type casted in terms of their behaviour and communication, and are anticipated to
communicate in a defined. With changes in time and trends of healthcare and expansion of

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job responsibilities of the nurses, it is required that nurses understand the requirement of
different sets of communication skills like assertive communication. It is necessary that the
nurses understand that being assertive boosts their communication skills and help them to
grow as a professional. Various nursing literature have repeatedly called for teaching
assertive communication skills to the nursing students as part of early learning, as well
encourage them to practice by role play or in real life situations. It is required that all nursing
professional should interpret that being emphatic is not similar to being assertive in a
negative direction and showing aggression but is a foremost sign of self-assurance that helps
a person to have confidence in one's own work and believe in once own set of ideas.
From this report, it can be concluded that communication play vital role in order to
develop trust and confidence within the patient and their family members. In accordance with
the case, a patient was bought to the hospital with head injury and got unconscious. Their
family members where waiting for long time in the waiting room. They are really upset for
not providing them proper information regarding what had happened to the patient. As per
the situation, it is important to have assertive communication that will enable to convey the
information. Further, there are two models for practising assertive communication. Among
the two, five steps model is taken into consideration. Further, it is essential to have proper eye
contact and to deliver information by stating their name. This is helpful in conveying the
information and to make their situation under control.

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References
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